🫀 Myocarditis & Pericarditis – What’s new in the 2025 ESC vs ACC criteria? This review from the Italian Society of Cardiology nicely compares the new ESC 2025 guidelines and the ACC consensus on inflammatory cardiac diseases — and some changes really matter for daily practice. 🔍 Myocarditis – Diagnostic criteria ESC 2025: • Definite = clinical syndrome + CMR or biopsy confirmation • Possible = clinical syndrome + ≥1 of: ECG changes, troponin rise, echo abnormality • Unlikely = symptoms without objective findings 👉 CMR is now the main diagnostic tool; biopsy only in selected/high-risk cases ACC: • Similar logic, but introduces 4 stages (A–D) from “at risk” to advanced disease 💢 Pericarditis – New criteria ACC: • Chest pain is mandatory • Plus ≥1 of: rub, ECG changes, CRP rise, effusion, or CMR inflammation • Definite if chest pain + ≥2 findings ESC: • Similar, but allows rare cases without chest pain if strong objective evidence 🔁 Overlap syndromes • Myopericarditis = pericardial-dominant • Perimyocarditis = myocardial-dominant • Troponin-positive pericarditis = higher risk → closer follow-up 🧲 Imaging • Echo first line • CMR = gold standard for myocarditis • CMR in complicated or recurrent pericarditis 💊 Therapy highlights • Pericarditis: NSAIDs + colchicine first line • Avoid early steroids if possible • IL-1 blockers (anakinra, rilonacept) = game changer for recurrent pericarditis 📌 Take-home: Diagnosis is now more imaging-driven, more structured, and more personalised — with CMR and biomarkers at the centre of decision making. #Myocarditis #Pericarditis #ESC2025 #ACC #CMR #CardiacImaging #Inflammation #Cardiology #Guidelines 🫀📚 Link:doi.org/10.1016/j.tcm.2026.0…